BARCELONA—Not only was breast conserving therapy safer than mastectomy for most low-risk patients in the large randomized EORTC 10041/BIG 03-04 MINDACT trial reported at the 2018 European Breast Cancer Conference but also many patients could be advised to avoid chemotherapy and radiotherapy altogether after assessing their risk as “low” by using a combination of clinical and genetic risk scores, the study concluded.

Emiel Rutgers MD, PhD, a surgeon at the Netherlands Cancer Institute and professor of surgical oncology at the University of Amsterdam said MINDACT found an overall five-year loco-regional recurrence rate of only 2.1 per cent in patients treated conservatively and 2.5 per cent in those who had mastectomy. Tumor size and grade were the only independent risk factors and the results provided “the opportunity to prospectively study de-escalation of radiotherapy in women with low-risk early breast cancer”. He discussed his study and the clinical implications for the Audio Journal of Oncology.